Best Practice

VFSS Best Practice Recommendations

Standardization of all aspects of a videofluoroscopy is critical to ensure that results can be compared across: 1) time points (e.g. pre vs. post), 2) individuals, 3) clinicians, 4) research studies, and 5) to translate research to clinical practice. We strongly recommend adopting standard approaches to each of the following aspects of videofluoroscopy below. To see a summary of VFSS best practice recommendations, click here.

Barium Recipes

Professor Steele is an advocate of using standardized stimuli for assessment in videofluoroscopy.  Currently, there are no commercially available barium preparations designed for videofluoroscopy in Canada.  However, in the United States, the industry standard has become a commercially-available 40% w/v density preparation (Varibar). To access recipes on how to prepare barium using materials that are currently available in Canada, click here.

Videofluoroscopy Frame Rate

In a videofluoroscopy exam, the aim is to capture the highest image quality possible while being responsible about limiting unnecessary radiation exposure. For information on videofluoroscopy frame rate, click here.

VFSS Analysis

In April 2019, the Swallowing Rehabilitation Research Lab (SRRL) published a new article on videofluoroscopic swallow study (VFSS) reference values in healthy swallowing, across the range from thin to extremely thick liquids according to the IDDSI framework. The VFSS analysis process was titled the ASPEKT Method (Analysis of Swallowing Physiology: Events, Kinematics and Timing).

In November 2019, the SRRL introduced the ASPEKT-C Method (Analysis of Swallowing Physiology: Events, Kinematics and Timing for Use in Clinical Practice), a simplified VFSS analysis approach to assist clinicians in identifying the underlying mechanisms leading to impaired swallowing safety and efficiency.

To learn more about the ASPEKT and ASPEKT-C Methods click here.